In CMS
Mar 20th, 2017
Physicians may provide “professional courtesy” discounts to other physicians, as well as to those with whom they work or have a personal relationship (e.g., office staff, hospital employees, and family members). Professional courtesy services can create legal liabilities under Stark anti-kickback laws, which define the practice as “the provision of free or discounted healthcare items ...
In CMS
Feb 28th, 2017
New compliance program guidance has been issued by the Fraud Section of the Department of Justice (DOJ), according to an article published in the AHLA Weekly. Although the “Evaluation of Corporate Compliance Programs” (Guidance) is not specific to the healthcare industry, it does provide a practical set of benchmarks against which the audit & compliance committee, in ...
Feb 27th, 2017
The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient. As of Jan. 1, 2017, CMS has made an exception and will now allow Medicare coverage for non face-to-face prolonged service codes 99358 Prolonged evaluation and management service before ...
In Billing
Jan 25th, 2017
Locum tenens is a Latin phrase that means, “to hold the place of.” In medicine, locum tenens are contracted physicians who substitute for a physician who has left the practice, or who is absent or otherwise unavailable. The Centers for Medicare & Medicaid Services (CMS) allows payment to the regular physician for services provided during ...
Jan 20th, 2017
The American Health Lawyers association reported the following in its weekly Fraud and Abuse update: The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual ...